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The Senate Has Presented An Obamacare Replacement Bill: Will The Swamp Win And Defeat A Healthcare Bill?

ArmchairPolitiicianTrumpSwampHealthcare, June 22, 2017, by Brad Peery, WWW.ArmchairPolitician.US, ArmchairPolitician.US@gmail.com

The Senate has introduced a more moderate Obamacare replacement bill than the one passed in the House. There will be 20 hours of debate, with the opportunity to consider amendments. There is no Democratic support. It will be interesting to see if there are any Democratic Senators that vote for the bill, once possible amendments have been considered. Getting a Democratic vote seems unlikely.

The key elements of the Senate Bill are outlined below.

People with pre-existing conditions remain covered. Each such person costs five times as much as a healthy individual. People with pre-existing conditions are responsible for 55% of the cost of the Bill.

Obamacare requires all Americans to buy health insurance or pay a tax penalty, with exceptions for people who have experienced hardships. This has penalized young people who do not want health insurance. The penalties are eliminated under the Senate Bill. States are enabled to design health policies for young people. Seven million young people did not take health insurance, making overall healthcare more expensive than was expected. A popular feature that is retained, through age 26, is coverage for children by their parents.

Obamacare imposed new taxes to help pay for coverage expansion. They include taxes on investment income, wages above $200,000, medical devices, prescription drugs and indoor tanning. Most Obamacare taxes are repealed. The exception is a tax on high cost employer health plans, established under Obamacare, but yet to kick in, would be imposed beginning in 2026.

Medicaid is a federal government program to help provide healthcare coverage to certain categories of people who have low income and few assets (other than the home they live in). Each state runs its own version of Medicaid, with slightly different rules and coverage. Medicaid covers 69 million people. The Bill allows the 31 states that expanded Medicaid to continue getting increased federal funding through 2021, with reduced funding starting in 2021 that takes the coverage to current levels in 2024. Separate from the expansion, the bill caps the amount per enrollee, based on how much each state has spent historically. States also have the option to receive a lump-sum block grant for some beneficiaries.

Obamacare has been a failure. Next year, 41% of the counties in the U.S. will have only one insurer. That is double the number this year. Premiums have skyrocketed, with premium increases averaging 105% since 2013. To encourage insurers to come back into the market, billions of dollars will be spent to stabilize the insurance markets. The subsidies will be $15 billion, in 2018, and will drop to $10 billion from 2019 to 2021.

Health saving accounts are reinforced to allow such savings accounts to be used to help pay for future healthcare costs. In 2017, Obamacare allows an individual to put $3,400 and a family to put $6,750 into a tax-free health savings account. The Senate bill allows people to put more money into their health savings accounts, up to the maximum allowed for out-of-pocket costs, and lets spouses make additional contributions.

Tax credits for premiums are currently available to middle-income Americans. The Senate bill reduces the threshold for getting assistance from 400% to 350% of the poverty level. Younger people would pay less and older people more as a share of their incomes. The bill also expands the subsidies to Americans living below the poverty line, who were ineligible under Obamacare.

Obamacare provides subsidies to help people with lower incomes pay for out-of-pocket costs like deductibles and co-payments. The Senate Bill preserves the subsidies through 2019, then eliminates them altogether.

Under Obamacare, an employer must provide insurance if an employee works 30 hours or more per week. This has caused employers to reduce the hours of some employees to under 30 hours, essentially increasing unemployment. Employer mandated insurance is eliminated under the Senate Bill.

Older people are facing the possibility of paying substantially more for coverage. Obamacare limits insurers selling policies to individuals from charging their oldest customers more than three times what they charge their youngest ones. The Senate Bill allows insurers to charge older customers as much as five times the level of premiums for younger ones.

The Senate Bill increases states’ abilities to apply for waivers from the Obamacare insurance requirement. This could increase the flexibility of states to provide different health plans tailored to their states.

ArmchairPolitician.US Opinion:
The outcome in the Senate is uncertain. Obamacare needs to be substantially altered. However the Republicans can only lose two Senators to get to the required 50 votes. There are four senators that are so far opposed to the Bill. Trump vowed to drain the swamp, but there are Republican Congressmen and Senators that in our opinion are part of the swamp, including Ted Cruz, and Rand Paul and members of the House Freedom Caucus. If a bill is not agreed to by the House and the Senate, the swamp, including the obstructionist Democrats, will have won and done a disservice to the American people.

See:
ArmchairPolitiicianObamacare, April 24, 2017, by Brad Peery, WWW. ArmchairPolitician.US
Medicaid Is A Key Component Of Obamacare Replacement : What Are The Issues

See Also:
ArmchairPoliticianObamacare, March 1, 2017, by Brad Peery, WWW.ArmchairPolitician.US
Obamacare Repeal and Replacement Update

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